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Impact of Tracheotomy and Its Timing on Outcomes in Pediatric Patients with Prolonged Mechanical Ventilation: A

Pan Liu1, Yang Chen2, Zihao Yang3

  • 1Department of Pediatric Intensive Care Unit, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.

Respiration; International Review of Thoracic Diseases
|August 28, 2025
PubMed

Insights

Tracheotomy may improve survival for children on prolonged mechanical ventilation (PMV). Early tracheotomy was linked to shorter intensive care unit stays, but timing did not significantly affect overall outcomes.

Area of Science:

  • Pediatric critical care medicine
  • Respiratory medicine
  • Surgical interventions

Background:

  • Prolonged mechanical ventilation (PMV) poses significant challenges in pediatric intensive care.
  • Tracheotomy is a potential intervention for managing PMV, but its impact and optimal timing require further investigation.

Purpose of the Study:

  • To evaluate the association between tracheotomy and outcomes in pediatric patients requiring prolonged mechanical ventilation (PMV).
  • To determine if the timing of tracheotomy influences survival and other clinical outcomes.

Main Methods:

  • Multicenter retrospective study of 719 pediatric patients (29 days to 18 years) requiring PMV.
  • Patients were categorized by tracheotomy status (yes/no) and timing (early, intermediate, late).
  • Primary outcome: 180-day survival; Secondary outcomes: weaning success, VAP incidence, PICU length of stay.

Main Results:

  • Tracheotomy was associated with significantly higher 180-day survival (aOR 1.98).
  • No significant differences in weaning success or VAP incidence were observed between groups.
  • Early tracheotomy correlated with shorter PICU stays compared to intermediate or late procedures.

Conclusions:

  • Tracheotomy may be linked to improved 180-day survival in pediatric PMV patients.
  • The timing of tracheotomy did not show a clear association with primary outcomes in this study.
  • Further large-scale, diverse studies are needed to confirm these findings and explore residual confounding.
Abstract

Keywords:
Intensive care unitPediatric patientsProlonged mechanical ventilationTracheotomyWeaning

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